Expanded midwifery services could save millions of lives – UN

20 June 2011  Up to 3.6 million deaths could be avoided each year in 58 developing countries if midwifery services are upgraded, according to a report released today by the United Nations Population Fund (UNFPA) and partners.

The study, The State of the World’s Midwifery 2011, estimates that an additional 112,000 midwives need to be deployed in 38 countries to meet their target to achieve 95 per cent coverage of births by skilled attendants by 2015, as required under the Millennium Development Goals (MDGs). Globally, 350,000 midwives are still lacking, it says.

The report, launched at the Triennial Congress of the International Confederation of Midwives (ICM) Durban, South Africa, says if adequate facilities were accessible to deal with complications at their onset, many deaths could be averted: 61 per cent of all maternal deaths; 49 per cent of all stillbirths; and three in every five newborn deaths.

The report adds that if midwives are in place and can refer the most severe complications to specialized care, up to 90 per cent of maternal deaths could be prevented.

“Ensuring that every woman and her newborn have access to quality midwifery services demands that we take bold steps to build on what we have achieved so far across communities, countries, regions and the world,” said Ban Ki-moon, Secretary-General of the United Nations, in his foreword to the report.

Each year, 358,000 women die while pregnant or giving birth, some two million newborns die within the first 24 hours of life and there are 2.6 million stillbirths, it says.

“The report points to an urgent need to train more health workers with midwifery skills and ensure equitable access to their life-saving services in communities to improve the health of women and children,” said Babatunde Osotimehin, Executive Director of UNFPA.

UNFPA supports midwifery training programmes in 30 countries, including, for example, some 18 schools in Ethiopia. A UNFPA official said the agency will integrate the report’s findings in its current curricula and plans an expansion of UN midwifery training programs.

The report, a result of collaboration among 30 partners, including the UN Children’s Fund (UNICEF) and the World Health Organization (WHO), surveyed 58 countries, which together account for just under 60 per cent of births worldwide and yet 91 per cent of all maternal deaths.

Among the 38 countries most desperately in need of midwives, 22 need to double the workforce by 2015; seven need to triple or quadruple it; and nine – Cameroon, Chad, Ethiopia, Guinea, Haiti, Niger, Sierra Leone, Somalia and Sudan – need to dramatically scale up midwifery by a factor of between six and 15, it says.